Three-Quarters of Surgeons Believe 24/7 NHS Care Not Achievable

Surgeons support extension of consultant-led care but doubt it can be delivered under current system.

A survey by the Royal College of Surgeons of Edinburgh (RCSEd) has revealed that 75% of its membership do not believe 24/7 consultant-led NHS services are achievable under the current service model. Of those in training grades, a higher proportion did not think the reforms were achievable, with just 9% believing they were.

The findings are published as the Government is introducing plans to offer patients access to consultants seven days a week in England, where the RCSEd has around 11,000 Fellows and Members.

Despite the concerns, 76% of those surveyed agreed that the NHS should offer around-the-clock services, with those in general, cardiothoracic, and vascular surgery showing levels of agreement over 80%.

The College also found that just one quarter of respondents felt their employer had sufficient surgical capacity at the appropriate grade, with almost half (47%) saying there was not sufficient capacity.

President of the RCSEd, Mr Ian Ritchie said:

“Patients rightly expect the same standards of care at night and weekends as they would receive during normal working hours. We support this, and know that our membership is strongly in favour of round the clock services. However, they also have concerns about the feasibility of such reforms and only a limited number feel there is sufficient capacity at the appropriate grade under the current service model.

“Therefore it is imperative that services and rotas are designed so that consultant led care is possible throughout the week. This will require both an increase in the number of consultants and the generalist capacity across the surgical workforce.

“It is also vital that these clinicians are able to access diagnostic services, such as scans and tests, at nights and weekends so they are not delayed in their efforts to treat patients effectively.

“However we must also recognise that NHS staff are entitled to a work-life balance, and that family responsibilities and other commitments mean that not all consultants will be able to work evenings and weekends at every stage of their career.”

Richard McGregor, RCSEd Trainee Member of Council and Chair of the College’s Trainees’ Committee which represents trainee surgeons throughout the UK said:

“Everyone who works in healthcare is committed to achieving the highest standards in patient care and the results show that my colleagues - trainees and consultants alike - understand the importance of delivering that care within the context of 24/7 services. This is primarily because we, and our colleagues across all specialties, are already delivering care within that context in hospitals throughout the UK.

“However, the results also recognise that it is not the willingness of those who work in healthcare that is the issue, it is that, under the current service model, the reforms outlined recently by Jeremy Hunt to contractually formalise such care will not result in the 24/7 NHS which is everyone’s aim.

“Doctors form a small part of the multi-faceted, modern NHS. We work within a multi-disciplinary team and, in order to truly achieve a service that is consultant delivered 7 days a week, money needs to be invested and capacity increased in all areas of the NHS - both within hospitals and, crucially, within those services which are delivered in the community. Simply asking doctors to work more hours will not solve the problem, and may introduce new problems relating to the health and wellbeing of the workforce which would ultimately negatively impact patient safety. Proper investment in infrastructure and capacity throughout the NHS, however, will support all healthcare professionals to deliver the services that our patients need and deserve."

Over 1000 members of the UK’s largest and oldest surgical college took part in the survey on a range of professional issues, including the length of training and the publication of surgeons’ outcome data. RCSEd members also said it was important to have the opportunity to work less than full-time (77%), while just over one quarter (28%) felt their employer was supportive of it.

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